Tamoxifen after total hysterectomy and ovary removal

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One year ago, I was diagnosed with DCIS. The tumor was excised successfully with free margins but the words "microinvasive" were used. To be on the safe side, my surgeon performed an axillary node dissection and all nodes were negative. I received 25 radiation treatments and was prescribed Tamoxifen. The Tamoxifen caused severe bleeding to the point that I recently underwent a total hysterectomy. My question: I'm confused about the fact that since I no longer have ovaries to produce estrogen, how does the Tamoxifen help me? Is there anything I can take for hot flashes? Thank you for this Internet site; it has been the most informative site.

Kevin Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

Tamoxifen doesn't "need" ovaries present producing estrogen to be valuable. It is just as effective in women who have had a hysterectomy. For patients with hot flashes, we generally recommend a drug called Effexor. You should discuss it with her doctor to see if it may be indicated in your particular circumstance.

Mar 18, 2010 - The decision to perform prophylactic bilateral oophorectomy at the same time as hysterectomy should be taken with caution as it may do more harm than good, especially in women not at high risk for development of ovarian or breast cancers, according to a review published in the March issue of the Journal of Minimally Invasive Gynecology.